| NPI | 1407811433 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201704492NPPP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5007105) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 5007105) | |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2023-04-21 |